Done with 2020? Think 2021. Sign Up for Health Insurance Now

Free and low cost coverage options are available, especially to those who have lost jobs or are making less than before.

9:58 PM

Author | Kara Gavin

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No doubt about it, most of us are ready to be done with 2020.

So here's a chance to look ahead, past this difficult time, to the clean slate of 2021.

That's right, now is the time for most people to sign up for a health insurance plan for next year.

Sure, it's not the most exciting topic to think about. But at least it's something you can do now and feel in control about for next year.

It's especially important if you lost your health insurance in 2020 because of a lost job, or having to cut back on your work hours – or you haven't had insurance this year at all.

A pandemic is no time to have the wrong plan, or to go without health insurance if you can possibly avoid it.

Of course, since it's 2020, there's a catch.

Health insurance laws may change in 2021, depending on the outcome of the election and a Supreme Court case that will be argued as soon as November. The court's ruling may not come out until the spring.

If the Supreme Court rules the Affordable Care Act is unconstitutional, and the 2021 Congress and President can't agree on a way to fix the technical issue that's at the center of the court case, some insurance programs that cover millions of Americans may have to end. Others may change dramatically, or significantly.

But for now, those plans and programs stay the same, and it's time to make your choice before the deadline.

"Given our current state with the COVID crisis and unemployment, now more than ever, it is important for people to make sure they have health insurance," says Alena Hill, who oversees a team of patient financial counselors at Michigan Medicine, the University of Michigan's academic medical center. "Open enrollment is the perfect time for everyone to enroll into an insurance plan, review their current coverage, or even see if they qualify for government assistance plans such as Medicaid."

Hill's team is available to counsel anyone, even those who have not been patients at U-M, on their options. They answer questions via email and a toll-free phone number, and help thousands of people each year find health insurance or low-cost care.

Here's a quick guide to your options:

If you get insurance through your job, or a family member's job:

Most employers that offer insurance benefits use October and November as Open Enrollment time for the next year's plans. Make sure you know your deadline.

If you have a choice of plans, choose wisely. Don't just look at the amount the plan will cost you each month – look at the amount you'll have to pay if you go to a doctor, emergency room or hospital.

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If you choose a plan with a high deductible – the amount you'll have to pay for care before your insurance kicks in – then it's important to also have money on hand in case you get sick. You can save that money, bit by bit, in a special kind of savings account. You don't get taxed on the money that you put in the account.

The good news: If you have a health condition, you won't get kicked off your employer's plan even if the Affordable Care Act is ruled unconstitutional in 2021, and even if there's no fix to keep it going or replace it. An older law protects people in group insurance plans from this. But if you have a pre-existing condition, an overturned ACA will affect the kind of insurance you can find if you want to leave that job or you lose your job.

SEE ALSO: Keeping Our Patients Safe During COVID-19

The bad news: The Affordable Care Act means that you don't have to pay anything for certain kinds of preventive care, and that you can cover a grown child under age 26 through your plan. These provisions, and others, may change if the law is struck down in court and there's no fix or replacement.

If you have Medicare:

This is Open Enrollment season for Medicare, through December 7. Even if you're happy with the Medicare option you've had in 2020, it might be worth looking at the website, touching base with your state's Medicare navigator program or calling 1-800-MEDICARE (1-800-633-4227).

The good news: There's a new online tool that helps you compare different plans, including prescription drug plans, to find the one that works best for your needs. And there's a new benefit that will reduce the cost of insulin for people with diabetes who use it, depending on which plan they choose. The Affordable Care Act's fate in court won't affect coverage for doctor and hospital care.

SEE ALSO: Pandemic Hitting You in the Wallet? How to Find Health Coverage or Low-Cost Medical Help

The bad news: The Affordable Care Act closed a 'donut hole' for prescription drug costs that previously affected people with Medicare Part D, and meant that some people had to pay hundreds or thousands of dollars for their drugs until catastrophic coverage kicked in. If the ACA goes away, the donut hole may come back unless Congress and the president fix it in 2021.

If you have an insurance plan you bought directly:

Millions of people buy their insurance through the federal Marketplace, and Open Enrollment for those plans begins on November 1 and goes through December 15. The Michigan Medicine team can help you evaluate your options, or you can find other free help. Even if you like the plan you've had in 2020, you should check what's available for 2021.

The good news: New plans have entered the Marketplace, and some plans have lowered their rates. If your income has gone down in 2020 and may stay down in 2021, you might be eligible for financial help even if you weren't before. Those discounts or subsidies can really lower your costs.

The bad news: The Affordable Care Act created the Marketplace and funded the financial assistance for people with certain income levels. It also required plans sold on the Marketplace to cost the same for everyone, even people who have pre-existing conditions. Although health insurance companies may still allow you to buy insurance directly if the ACA is overturned with no replacement, the government won't help with costs, and companies could charge more for people with health conditions.

If you have a Medicaid plan or another plan from your state:

Most states have expanded their Medicaid programs to allow all people with low incomes to enroll. In Michigan, this is called the Healthy Michigan Plan, and it covers more than 812,000 people. There are also other 'safety net' programs for children and adults that vary by state; here's a list of the ones in Michigan.

If you have this kind of coverage, there's no Open Enrollment period – enrollment happens all year. But you should make sure to understand what you need to do to stay in your plan. That includes annual renewals (also called redetermination) and new requirements if you've had Healthy Michigan Plan coverage for four years or more.

The good news: People who lost jobs or work hours due to the pandemic may qualify for this kind of 'safety net' coverage even if they didn't before. If you used to have this kind of coverage, but lost it or left it when your income rose, you can re-enroll if your income has dropped again.

SEE ALSO: Seeking Medical Care During COVID-19

The bad news: The Medicaid expansion plans, such as the Healthy Michigan Plan, were made possible by the Affordable Care Act, which provides federal money to help states cover more people. If the ACA is overturned and no replacement or fix is put in place, these plans could go away.

If you don't have insurance right now:

To put it plain, being uninsured in the middle of a pandemic is not wise. If you catch the coronavirus and get COVID-19, or if you get sick or injured for any other reason, you may need care that can cost a lot of money.

While health care providers may be able to get federal dollars to cover COVID-19 testing and care if you need it, you could still be on the hook to pay part of the cost.

SEE ALSO: The ACA Turns 10 and Faces a Pandemic, an Election and a Supreme Court Case

The good news: If you lost your insurance because you lost your job this year, you can buy a plan on the Marketplace for the rest of 2020. If you're over age 65 but haven't enrolled in Medicare yet because you used to get insurance through a job you've now lost, you may be eligible for a special Medicare enrollment period. If your income has dropped enough you may now be eligible for a Medicaid expansion plan. See if you might be eligible for any of these options.

For 2021, visit the Marketplace site starting Nov. 1 to see what options you have for buying coverage and getting help with the cost. You must enroll by December 15. This site can also tell you if you might be eligible for Medicaid.

The bad news: If the Affordable Care Act is overturned in court without a replacement or fix, many of the plans and programs for uninsured people will go away or be reduced. And the free and low-cost clinics that take care of uninsured people won't receive additional payments from the federal government so they may have to cut back on services.

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More Articles About: Health Management Health Care Delivery, Policy and Economics Covid-19 Wellness and Prevention infectious disease
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